Catch & Deliver: A Critical Analysis of Language in Childbirth

As a woman who spends a lot of time with words, I am curious to know the deeper meaning with how words are used to describe things. Of course, with my interest in pregnancy and childbirth, I have examined words and phrases that hold more than just letters strung together. Looking up the etymology of words common to contemporary childbirth, I found some things of interest that show the contrast between the art of midwifery and hospital managed birth.

Midwife comes from the combination of Middle English words mid (with) and wif (women). It is a woman assisting, literally a woman who is with the mother at birth. Conversely, the root word of obstetrician is obstetric, from modern Latin word obstetricus meaning “pertaining to a midwife”. To further break down the word obstetric, it comes from the word obstare, which means to stand opposite to. What I found interesting further still is that in my etymological research, I was directed to the word obstacle. Gynecology comes from the French word gynécologie, meaning the study of women. It is the medical practice dealing with the health of the female reproductive system.

Historically, the field of obstetrics and gynecology stems from the medical establishment in Western society purposely becoming an obstacle to women-centered healthcare. It was a specialization for male doctors in the time when women were not permitted to be educated. According to the book, “Witches, Midwives and Nurses: A History of Women Healers” by Barbara Ehrenreich and Deirdre English, the destruction of the midwifery profession was intentional. The patriarchal institutions of the church and the medical system effectively demonized women healers and convinced countless women that they were safer in an operating room than with knowledgeable women who practiced with empirical evidence and compassion; male-led obstetrical care has a violent history of coercion, abuse and unnecessary procedures that were based on superstition and unfounded assumptions.

Dr. James Marion Sims is known as the father of American gynecology. His statue sits on a pedestal in Central Park on 103rd and Fifth Avenue in East Harlem, commonly known as Spanish Harlem. His presence in that community is a slap in the face. It is an abomination. He is credited with developing life-saving surgical procedures involving a way to repair vesico-vaginal fistula and the creation of the speculum. This would be a praise-worthy achievement if it were not connected to a terrifying history of torture. Sims operated on at least 10 enslaved women from about 1845 to 1849, with one woman named Anarcha enduring thirty surgeries without anesthesia. There are accounts of him performing these surgeries on a stage with an audience of men watching these atrocities. The procedures then were used to assist and save white middle class women and in contemporary times, these techniques are certainly valuable. However, we must not forget the violence that they were wrought out of.

Midwifery is antithesis of the current medical model of birth. The vocabulary and terms used by holistic and humanistic midwives is an indication of our views on women and birth. Midwives catch babies. Obstetricians deliver babies. To define catch, it means to intercept and seize, implying taking hold suddenly of something. It also means to receive. On the other hand, to deliver is to hand over and yield. Synonyms for deliver include emancipate, release, redeem and rescue. In this instance, it is clear that though both actions are anything but passive, delivering a baby connotates that there is some impending doom to be avoided by intervention. Midwives are with women and hold the space for birth. Midwives view birth as a natural process of a woman’s life. Obstetricians and hospitals manage birth, implying that birth is a pathological emergency that must be brought under control. It is common to hear obstetricians speak about a woman’s “failure to progress” because of her “incompetent cervix”. These statements are from a deeper misconception that the world holds about women: that they are weak, fragile and in need of being saved, ultimately controlled and coerced by the patriarchal system in place.

Undoubtedly, childbirth is hard. There are occasions in which the use of pain medication is merciful and welcome; the problem is the routine use of epidurals and pitocin that have more harmful side effects than medical professionals are telling their patients. There is a clear power dynamic that exists in which women are treated collectively as inferior by the medical establishment. With all the statistics on the unnecessary interventions performed on women during labor and delivery aside, the words and phrases we use carry a lot of baggage. Particularly in the field of childbirth, our vocabulary works on the subconscious in ways we are not yet privy to. In examining how we frame our communication about childbearing women, we can practice liberation from violence in just the way we speak.

Reference:
Slaves, Experiments & Dr. Marion Sims’s Statue: Should It Stay or Go? – http://newamericamedia.org/2010/12/dr-marion-sims-statue-where-should-it-stand.php

Sandra Iturbe: Una Madre Sabia – A Wise Mother

IMG_0170 It is a marvel to observe wisdom flow through a woman in her motherhood. Sandra Iturbe moved   through her kitchen with the grace of generations of Mexica women and mothers whose knowledge she has inherited. As a certified professional midwife living in El Paso, Texas, she considers herself a birth activist. On the day after her birthday, Sandra sat down to share her journey. The house spoke of quiet with daughter Yolotzin napping nearby. Painted masks enlivened one wall of the peaceful room. Two inviting couches faced a television set as the midday sunlight poured into the living room. A bookcase showed rows of childbirth books, coupled with anatomy textbooks and journals.

In her kitchen, she tidied up while preparing to speak. “I’m multitasking,” she mused as she moved around me in a blue shirt, black skirt and black shawl. She braided and rebraided her long thick black hair as we spoke. Sandra’s striking brown eyes were brought out by her black eyeliner; her brilliant smile and jovial speech accented by matted red lipstick. She awaited her family and community, whose support give her strength on her path.

Sandra came into the world in California to her parents who migrated from Mexico to Los Angeles. They worked in the maquiladoras (assembly plants) to support Sandra and her two older siblings. Her family lived there until Sandra was 5 years old. They moved to El Paso to be closer to their extended family. She followed in her older sister’s footsteps when it came time for college and majored in psychology in her undergraduate career. Sandra worked for a mental health crisis department providing support on a suicide hotline. She assessed clients for what kind of care they need, but overall found herself disenchanted with mental health field. She yearned for something more holistic.

Curiously enough, during this time, Sandra lived with some gringas (female American foreigners) who attended the midwifery school, Maternidad La Luz, which was across the street. She was fascinated by the stories her roommates had about midwifery and took to reading the books and watching videos about birthing. “All you talk about is birth as a midwife,” she said between laughter of her roommates who influenced her interest in midwifery with their stories. During this time, she came across birth anthropologist Robbie Davis Floyd and thought to get a degree in anthropology. Life had other plans for her.

Sandra applied to a post-graduate program and didn’t get in. Before she went on to become a midwife, she had to work through feelings of not being enough or deserving of such an education. “That’s not for people like me.” Her strong spirit helped dispel those thoughts. As she poured some more coffee, she remembered the moment when she began to study midwifery. She knew her community needed help transforming its women’s experience but was bothered that most of the women who came to study in El Paso did not stay. “You know what Sandra? You complain about how things are, that these women come and study and leave.” She applied and received a scholarship from Maternidad La Luz and a women’s fund, making it possible for her to attend.

Her time at Materndidad La Luz was an awesome time in life. She felt disconnected and connected at the same time. The demands of the midwifery program made it hard to spend time with her family and community; the work made her feel more connected to her ancestors and her life path. She shared that it was a culture shock, as the school attracts women who are mostly white. It wasn’t something common to her experience living in a mostly Chicano community. Sandra lost her mother to cancer at age 15. This wound began to heal on her midwifery journey as she grappled with feelings of envy and loss watching the woman she served give birth and bond with their newborns. Coupled with healing from this loss, the program at Maternidad La Luz was taxing. She was so exhausted from the long 24 hour shifts. Remembering this exhaustion, she laughed as she pretended to be her body’s voice, “I already told you 14 hours ago, go to sleep.” With the incredible journey she was on, she was very aware of what she needed to get through it.

“I don’t think I could have gotten through without community,” she stated tenderly. Sandra remembered being able to reach out to family and friends when she needed them. “Me haces sopita? Toy malita. (Would you make me soup? I’m sick)” In the same breath, her spiritual practices fortified her during her studies, citing her participation in ceremony as a grounding and healing part of her life then and now. After leaving Maternidad La Luz, Sandra began lactating. “My body wanted to become a mother,” she said as she reflected on the occurrence of producing milk before being pregnant. Three months later, she was with child.

“Motherhood makes me grateful; it makes me want to live intentionally. Life is less in my hands.” She spends her days mothering Yolotzin, who joined the conversation upon waking from her nap. The precious two year old walked into the kitchen and Sandra’s face lit up, gathering her in her arms, kissing her cheeks and asking about her nap and if her tummy needed some food. The memory of her mother is present. “She looks like me when I was little,” Sandra said. “I get it now. I get how you loved me,” she continued, speaking to her mother in the great beyond.

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Sandra is using the knowledge she has as a professional midwife to be a resource to women in her community. As a deeply spiritual person, she gives advice for pregnancy and other reproductive health concerns. She finds herself holding space for ceremony, helping women create ritual around important moments in their lives. Ceremony in her Mexica tradition has brought inspiration to her work and connects her to the ways of her ancestors. She shared with me how the Chicano activist movement has brought a resurgence of ceremony, with the surfacing of traditions such as kalpulis (ceremonial groups), Danza Azteca (traditional folk dance of the native people of Mexico) and temazcales (sweat lodge of indigenous Mesoamerican people). In sharing ceremony with women in prenatal and postpartum temazcales, as well as the larger community doing their healing work and ancestral veneration, she has found the well of her inherent wisdom on her path to truly being a madre sabia – a wise mother.

She conducted a series of workshops at one of the local yoga studios named Madre Sabia Childbirth Education. Her intention was to provide guidance and resources for all women and birthing circumstances, including home birth and hospital birth. Recently, she took a step back from the workshops to dedicate her time to her daughter and studying to be a certified nurse midwife. The women she wants to serve are still giving birth in the hospital. She wants to meet them where they’re at. “The reason I wanted to be a midwife is to serve community. Many women can’t pay out of pocket. The financial reality [in El Paso] does not lend itself to homebirth,” Sandra explains as part of the reason she has decided to continue her education. She knows it won’t be easy and not the way she wanted to learn midwifery yet knows it will have its benefits and consequences. Her optimism is contagious as she describes how the knowledge she is gaining will only benefit the women and families she assists.

In this stage of her womanhood, being a certified nurse midwife would give her the ability to support her family and be a mother. Ultimately, the wisdom her journey is bringing into focus will contribute to making her dreams come true. With Texas having one of the highest rates of pregnancy in the country, her goal is to help lower those numbers. She strives to encourage more women towards natural birth, empowering them to make informed and holistic choices.